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(2) TWOFOLD
INCREASE IN ADULT ASTHMA IN 20
YEARS, IRRESPECTIVE
OF SMOKING
(1) DRUG USE AND
HEPATITIS INFECTION ARE
WIDESPREAD IN IRISH PRISONS
(Prevalence of antibodies to hepatitis
B, hepatitis C, and HIV
and risk factors in Irish prisoners:
results of a national cross
sectional survey)
http://bmj.com/cgi/content/full/321/7253/78
Drug use and infection with hepatitis C
are endemic among
Irish prisoners, stressing the need for
scrutiny and
improvement of the Irish prison healthcare
system, according
to a study in this week's BMJ.
Researchers in the Republic of Ireland
surveyed over 1,300
prisoners aged between 16 and 67 years
of age who were
considered to be at medium or high risk
for blood borne viral
infections. The authors found 9% of prisoners
had evidence
of current or past infection with hepatitis
B, 37% with
hepatitis C and 2% with HIV. Drug use
is the most important
predictor of infection, say the authors.
Prisoners who
reported injecting drugs were 81 times
more likely to be
positive for hepatitis C and 22 times
more likely to be
positive for hepatitis B than non-drug
using prisoners.
Alarmingly, the authors also found that
21% of prisoners
reported that they had started to inject
drugs while in prison
and 71% reported sharing needles in prison
- clearly
increasing their risk of infection even
further.
In Ireland, as elsewhere, injecting drug
use in prison is here to
stay, say the authors. Despite improvement
in community
drug treatment services, the Irish prison
healthcare system has
not kept pace with the high rates of injecting
drug use and
sharing of needles within Irish prisons.
They call on policy
makers, researchers and clinicians working
in prisons to
implement measures to ensure that being
in prison does not
add to the health risks of this already
disadvantaged
population.
Contacts:
Fiona Bradley, Lecturer in General Practice,
Department of
Community Health and General Practice,
Trinity College,
Dublin 2, Republic of Ireland.
Email: fbradley@tcd.ie
Lelia Thornton, Specialist in Public Health
Medicine, Eastern
Regional Health Authority and Lecturer
in Public Health,
Department of Community Health and General
Practice,
Trinity College, Dublin 2, Republic of
Ireland.
Email: thornton@ehbph.iol.ie
(2) TWOFOLD INCREASE
IN ADULT ASTHMA IN 20
YEARS, IRRESPECTIVE OF SMOKING
(Intergenerational 20 year trends
in the prevalence of asthma
and hay fever in adults: the Midspan
family study surveys of
parents and offspring)
http://bmj.com/cgi/content/full/321/7253/88
The level of asthma in adults has increased
more than twofold
in 20 years, irrespective of smoking,
according to a unique
study in this week's BMJ.
Researchers in Scotland compared levels
of asthma, hay
fever and other chest problems in married
couples surveyed
during the 1970s with levels in their
offspring - surveyed at
similar ages - 20 years later. The authors
found that hay fever
and asthma increased during the 20-year
interval in both
smokers and non-smokers. In those who
had never smoked,
hay fever increased from 6% to 20% and
asthma increased
from 3% to 8%. In those who had smoked,
hay fever
increased from 5% to 16% and asthma increased
from 2% to
5%. During this period, smoking halved
in both men and
women.
Despite increased asthma, reports of frequent
chest wheezing
decreased over time. Besides the fall
in smoking, these
findings may be the result of improved
asthma treatment,
suggest the authors, as prescriptions
of inhaled steroid
medication for asthma increased more than
sixfold between
1980 and 1990.
Improved awareness of asthma does not appear
to be
responsible for the trend in allergic
asthma, conclude the
authors, but greater awareness may account
for trends in
non-allergic asthma. They stress the importance
of future
research to establish which types of asthma
are becoming
more common amongst adults.
Contact:
Mark Upton, general practitioner and clinical
epidemiologist,
Thornaby and Barwick Medical Group, The
Health Centre,
Thornaby, Cleveland TS17 0BZ
Email: marknupton@aol.com
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